This is an application from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania to serve as the Scientific and Data Coordinating Center (SDCC) for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study. Chronic renal insufficiency (CRI) affects over 20 million Americans with particular burden among older adults. The morbidity associated with chronic kidney disease (CKD) derives from frequent progression to end-stage renal disease (ESRD), a disproportionate risk of cardiovascular events, and other morbidities associated with disability and high costs of care. A set of etiological factors is being identified as potentially responsible for both progressive renal disease and morbidities in the setting of CKD, especially those operating early in the course of CKD when progression may be forestalled. These factors include clinical, behavioral, and those associated with biomarkers. Characterizing relationships between these risk factors and outcomes will permit development of instruments to predict poor outcomes in patients with CRI and enhance understanding of the etiological mechanisms leading to these outcomes. Improved prediction will allow identification of high-risk subgroups with CRI, thus guiding enrollment into preventive treatment trials and application of preventive therapies. The proposed third phase of CRIC will combine the study of these current CRIC participants along with 1,500 additional study participants to address overarching goals of understanding the relationship between kidney disease and the risks of cardiovascular and other types of morbidity. In particular, during Phase III, CRIC's SDCC will continue to provide scientific, data analytical, and logistical support to the CRIC Research Network as it continues to address a diverse set of high-impact areas of investigation with expanded emphasis on CKD in older adults, patients with moderate levels of CKD, and the burden of morbidity in patients with CKD. The CRIC Study cohort is an unparalleled resource that will also expand our ability to conduct science related to CKD through additional collaborations throughout the renal research community and interactions with other epidemiologic studies worldwide.